Certification Regarding Rights to Unemployment Benefits

OMB 3220-0079

OMB 3220-0079

In administering the disqualification for the voluntary leaving of work provision of Section 4 of the Railroad Unemployment Insurance Act, the Railroad Retirement Board investigates an unemployment claim that indicates the claimant left voluntarily. The certification obtains information needed to determine if the leaving was for good cause.

The latest form for Certification Regarding Rights to Unemployment Benefits expires 2023-09-30 and can be found here.

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No material or nonsubstantive change to a currently approved collection 1989-04-10
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No material or nonsubstantive change to a currently approved collection 1989-04-03
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Revision of a currently approved collection 1988-12-27
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Revision of a currently approved collection 1984-12-19
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Extension without change of a currently approved collection 1981-11-17
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No material or nonsubstantive change to a currently approved collection 1981-05-28
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No material or nonsubstantive change to a currently approved collection 1981-03-21
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Reinstatement with change of a previously approved collection 1981-02-19
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Revision of a currently approved collection 1979-12-27
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Extension without change of a currently approved collection 1974-10-29

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